The Role of Social Media in Investigating Insurance Fraud

July 5, 2016

The Role of Social Media in Investigating Insurance Fraud
By Michael Riedyk

A Bugatti driver drove his beautiful car off the road and into the ocean. Why? It turns out the driver had insured his million dollar car for more than two million. He claimed it was an accident, but the insurance company found the action caught on video on YouTube: sufficient evidence to deny the claim and convict the driver of what the industry calls the largest single attempted car insurance scam in history.

Industry studies have found that fraudulent insurance claims make up 10-20% of all claims costs, stealing $80 billion a year. This impacts everyone by raising premium prices for all policyholders. In 2015, Canadian auto insurer, ICBC opened approximately 7,500 fraud investigations, which included almost 5,000 claims investigations. The work of its special investigations unit led to a 98% conviction rate on all charges.

Insurance fraud can come in a variety of forms, including the following, of which we will focus in more detail.

1. False Claims

In other words: Pretending something has happened that really has not.

A man reported to police and his auto insurance company that his perfect truck had been vandalized. When investigators dug in, they found the same truck listed for sale on Craigslist, with the description admitting he was selling because the repairs were too expensive.

2. Exaggerated Claims

In other words: Pretending you are more injured than you are (unable to work).

A man collected $30,000 in benefits after claiming he was injured and unable to work. Photos on Facebook led the investigators to his gym, where undercover cameras caught him bench pressing five hundred pounds.

3. Organized Fraud

In other words: Pre-planning an event like a staged collision, or theft. Much like the Bugatti story.

Convictions of any form of fraud can “limit a person’s career options, prevent one from crossing the border and applying for credit, have claims completely denied, result in asset seizures, denial of optional insurance coverage, and other civil remedies.”

The Use Of Social Media In Investigations

As of 2015, 73% of US Americans had a social network profile. Moreover, Americans spend more time on social media than on any other major internet activity, including personal email.

For those reasons, social media is increasingly used as a tool in investigations of all kinds. Already, 86% of investigators are using social media 2-3 times per month in the course of their duties. As a result, these investigations help to solve crimes more quickly or prevent them from happening altogether. Social media is now particularly popular in investigating insurance fraud cases.

Some insurance companies hire specialized investigation teams to end suspicious social media activity that conflicts with what they stated to be true on their claims. This can involve investigating public status updates and photo shares, to using metadata to reveal when, where and how images were taken, to investigating comments posted on public forums and websites like Kijiji or Craigslist.

The manual labor aside, some insurance firms have employed technology to end suspicious patterns early in the claims process, before payments are made; others might employ the internet evidence finder.

With all these ways to get caught, fraudsters can have very little to defend themselves with when they get caught.

Digital evidence is easy to edit or fake. For investigators to be successful, they must learn how to sufficiently capture, collect and preserve such evidence in a way that is acceptable by the courts. Several courts have not accepted simple screenshots of web pages or social media digital data as legal evidence if parties were not able to prove data integrity and data authenticity of these digital files.

To collect web page or social media admissible evidence, the following advice should be followed:

• Place a 256-bit digital signature and a time stamp using a social digital certificate on all collected data to authenticate the collected evidence

• Obtain a screenshot of the social media page as a visual reference

• Obtain the source code of the web page in MHTML or WARC format for digital forensics analysis

• Prepare all metadata in EDRM-XML for import in eDiscovery workflow tools

Michael Riedyk is the co-founder of PageFreezer. PageFreezer is a SaaS (Software-as-a-Service) application that enables organizations and corporations of all sizes to permanently preserve their website and social media content in evidentiary quality and replay them as if they were still live. Uses for the archived data range from compliance with regulators such as the SEC, FINRA and the FDA to litigation preparedness, evidence capture, call center support and competitive intelligence.